This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Bruyere, O. Articles by Reginster, J.-Y. Search for Related Content PubMed PubMed Citation Articles by Bruyere, O. Articles by Reginster, J.-Y. Related Collections Calcium and Bone Metabolism

Relationship between Bone Mineral Density Changes and Fracture Risk Reduction in Patients Treated with Strontium Ranelate

World Health Organization Collaborating Center for Public Health Aspect of Osteoarticular Disorders (O.B., J.D., J.-Y.R.), University of Liège, B-4000 Liège, Belgium; Department of Rheumatology (C.R.), University of Paris, Hôpital Cochin, 75014 Paris, France; Clinique Générale Beaulieu (D.O.S.), CH-1206 Genève, Switzerland; Department of Rheumatology (T.D.S.), St. Thomas Hospital, London SE1 7EH, United Kingdom; Service de Rhumatologie (P.F.), Hôpital Nord, 80080 Amiens, France; Odense University Hospital (K.B.), DK-5000 Odense, Denmark; Université Catholique de Louvain (J.-P.D.), Saint-Luc University Hospital, B-1348 Brussels, Belgium; Fundacion Jimenez Diaz (M.D.-C.), Servicio de Medicina Interna, Unidad de Metabolismo Oseo, 28029 Madrid, Spain; University of Rome La Sapienza (C.A.), 00185 Roma, Italy; Gent University Hospital (J.-M.K.), B-9000 Gent, Belgium; and Department of Clinical Physiology (S.P.-N.), Hillerod Hospital, DK-3400 Hillerod, Denmark

Address all correspondence and requests for reprints to: Olivier Bruyere, Ph.D., Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart-Tilman, Bât B23, B-4000 Liège, Belgium. E-mail: olivier.bruyere{at}ulg.ac.be.

Objective: Our objective was to analyze the relationship between bone mineral density (BMD) changes and fracture incidence during 3-yr treatment with strontium ranelate.

Patients: Women from the strontium ranelate arm of the Spinal Osteoporosis Therapeutic Intervention study and the TReatment Of Peripheral OSteoporosis study were evaluated.

Outcome Measures: The outcome measures included BMD at the lumbar spine, femoral neck, and total proximal femur assessed at baseline and after a follow-up of 1 and 3 yr; semiquantitative visual assessment of vertebral fractures; and nonvertebral fractures based on written documentation.

Results: After 3 yr of strontium ranelate treatment, each percentage point increase in femoral neck and total proximal femur BMD was associated with a 3% (95% adjusted confidence interval, 1–5%) and 2% (1–4%) reduction in risk of a new vertebral fracture, respectively. The 3-yr changes in femoral neck and total proximal femur BMD explained 76% and 74%, respectively, of the reduction in vertebral fractures observed during the treatment. Three-year changes in spine BMD were not statistically associated with the incidence of new vertebral fracture (P = 0.10). No significant associations were found between 3-yr changes in BMD and incidence of new nonvertebral fractures, but a trend was found for femoral neck BMD (P = 0.09) and for total proximal femur BMD (P = 0.07). An increase in femoral neck BMD after 1 yr was significantly associated with the reduction in incidence of new vertebral fractures observed after 3 yr (P = 0.04).

Conclusion: During 3-yr strontium ranelate treatment, an increase in femoral neck BMD was associated with a proportional reduction in vertebral fracture incidence.

This article has been cited by other articles:

				N. A. T. Hamdy Strontium ranelate improves bone microarchitecture in osteoporosis Rheumatology, October 1, 2009; 48(suppl_4): iv9 - iv13. [Abstract] [Full Text] [PDF]

				B. Cortet Strontium ranelate: new perspectives for the management of osteoporosis Rheumatology, October 1, 2009; 48(suppl_4): iv1 - iv2. [Full Text] [PDF]

				B. Cortet Osteoporosis: from early fracture prevention to better bone health with strontium ranelate Rheumatology, October 1, 2009; 48(suppl_4): iv14 - iv19. [Abstract] [Full Text] [PDF]

				S. Ferrari Continuous broad protection against osteoporotic fractures with strontium ranelate Rheumatology, October 1, 2009; 48(suppl_4): iv20 - iv24. [Abstract] [Full Text] [PDF]

				C Roux, J Fechtenbaum, S Kolta, G Isaia, J B C. Andia, and J-P Devogelaer Strontium ranelate reduces the risk of vertebral fracture in young postmenopausal women with severe osteoporosis Ann Rheum Dis, December 1, 2008; 67(12): 1736 - 1738. [Abstract] [Full Text] [PDF]

				A. El Maghraoui and C. Roux DXA scanning in clinical practice QJM, August 1, 2008; 101(8): 605 - 617. [Abstract] [Full Text] [PDF]

				C. Roux Strontium ranelate: short- and long-term benefits for post-menopausal women with osteoporosis Rheumatology, July 1, 2008; 47(suppl_4): iv20 - iv22. [Abstract] [Full Text] [PDF]

				H Tilg, A R Moschen, A Kaser, A Pines, and I Dotan Gut, inflammation and osteoporosis: basic and clinical concepts Gut, May 1, 2008; 57(5): 684 - 694. [Abstract] [Full Text] [PDF]

				P. G Clay, L. E Voss, C. Williams, and E. C Daume Valid Treatment Options for Osteoporosis and Osteopenia in HIV-Infected Persons Ann. Pharmacother., May 1, 2008; 42(5): 670 - 679. [Abstract] [Full Text] [PDF]